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INTRODUCTION: The use of emerging tobacco and nicotine products affects tobacco use behaviors among college students. Thus, we aimed to examine transitions in tobacco use patterns and identify their predictors among smokers in a cohort of nursing students in Catalonia (Spain). METHODS: We conducted a prospective longitudinal study of Catalan nursing students between 2015-2016 and 2018-2019. We examined transitions in tobacco use patterns between baseline and follow-up among smokers from: 1) daily to non-daily smoking, 2) non-daily to daily smoking, 3) cigarette-only use to poly-tobacco use, 4) poly-tobacco use to cigarette-only use, 5) between products, 6) reducing consumption by ≥5 cigarettes per day (CPD); and 7) quitting smoking. We applied a Generalized Linear Model with a log link (Poisson regression) and robust variance to identify predictors of reducing cigarette consumption by ≥5 CPD and quitting smoking, obtaining both crude and adjusted (APR) prevalence ratios and their 95% confidence intervals (CIs). RESULTS: Among daily smokers at baseline, 12.1% transitioned to non-daily smoking at follow-up, while 36.2% of non-daily smokers shifted to daily smoking. Among cigarette-only users, 14.2% transitioned to poly-tobacco use, while 48.4% of poly-tobacco users switched to exclusive cigarette use. Among all smokers (daily and non-daily smokers), 60.8% reduced their cigarette consumption by ≥5 CPD and 28.3% quit smoking. Being a non-daily smoker (APR=0.33; 95% CI 0.19-0.55) and having lower nicotine dependence (APR=0.78; 95% CI 0.64-0.96) were inversely associated with reducing cigarette consumption, while being a non-daily smoker (APR=1.19; 95% CI: 1.08-1.31) was directly associated with quitting smoking. CONCLUSIONS: Nursing students who smoked experienced diverse transitions in tobacco use patterns over time. Evidence-based tobacco use preventive and cessation interventions are needed to tackle tobacco use among future nurses.
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OBJECTIVE: To analyze the prescription of drugs to aid smoking cessation and to detect whether there are differences by age or sex. DESIGN: Retrospective cohort study. SITE: Zamora Health Area. PARTICIPANTS: Persons with smoking cessation attempts employing drugs funded in the period from 2020 to 2023. INTERVENTIONS: Request of pharmaceutical consumption of varenicline, bupropion and cytisine to the Pharmacy Information System of the Regional Health Management of Castilla y León. MAIN MEASUREMENTS: Number of quit attempts per person, treatment drug, number of medication containers per attempt, year, age and sex. Descriptive and statistical analysis using SPSS© v. 20. RESULTS: 2581 people tried to quit smoking with drugs, 2206 made one attempt and 375 made several attempts. Mean age was 50.7 years (95% CI: 50.2-51.1). No significant differences were found for age (P=.71) or sex (P=.74). There was a preference for prescribing varenicline over bupropion and low drug compliance, with only one container of medication being collected in about 50% of cases. A total of 1680 attempts were made to quit using cytisine in 2023, equivalent to 55.4% of the total number of treatment drugs used in the four years. The estimated cumulative incidence rate of drug withdrawal attempts in smokers between 18 and 65 years of age was 11.9%. CONCLUSIONS: The drug intervention had a low reach and poor compliance with the recommended treatment. It is essential to emphasize patient follow-up and drug adherence.
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OBJECTIVES: The study aimed to evaluate the cost-effectiveness of the Pare de Fumar Conosco software compared with the standard of care adopted in Brazil for the treatment of smoking cessation. METHODS: In the cohort of smokers with multiple chronic conditions, we developed an decision tree model for the benefit measures of smoking cessation. We adopted the perspectives of the Brazilian Unified Health System and the service provider. Resources and costs were measured by primary and secondary sources and effectiveness by a randomized clinical trial. The incremental cost-effectiveness ratio (ICER) was calculated, followed by deterministic and probabilistic sensitivity analyses and deterministic and probabilistic sensitivity analyses. No willingness to pay threshold was adopted. RESULTS: The software had a lower cost and greater effectiveness than its comparator. The ICER was dominant in all of the benefits examined (-R$2 585 178.29 to -R$325 001.20). The cost of the standard of care followed by that of the electronic tool affected the ICER of the benefit measures. In all probabilistic analyses, the software was superior to the standard of care (53.6%-82.5%). CONCLUSION: The Pare de Fumar Conosco software is a technology that results in cost savings in treating smoking cessation.
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Abandono do Hábito de Fumar , Padrão de Cuidado , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Brasil , Análise de Custo-Efetividade , Tomada de Decisões , Árvores de Decisões , Abandono do Hábito de Fumar/métodos , Abandono do Hábito de Fumar/economia , Software/normas , Padrão de Cuidado/economiaRESUMO
OBJECTIVES: Tobacco consumption adversely affects general and oral health and is considered one of the significant public health burdens globally. The present study aims to assess the barriers and facilitators for attending oral and dental health screening among tobacco users who seek cessation advice. METHODOLOGY: The present mixed-methods study used group concept mapping (GCM) to identify the facilitators/barriers to attending oral health screening among young adults attending face-to-face and virtual Tobacco Cessation Clinic at King Saud University (Riyadh, Saudi Arabia) between September 2022 and April 2023. Study investigators included healthcare social workers, dental interns, and oral and maxillofacial medicinists. Information about demographics, general health, oral/dental health and tobacco use were collected using self-completed questionnaires. The barriers and facilitators were assessed following GCM by brainstorming, sorting, rating, and interpretation activities. Descriptive, multidimensional scaling and hierarchical cluster analysis were used to describe the study participants and produce concept maps of the generated statements. RESULTS: The study included 148 participants who generated 67 statements summarised into 28 statements as facilitators or barriers. Based on a 5-point importance scale, the participants indicated the importance of facilitators under health-related cluster [e.g. when I feel pain] as the highest, followed by personal [e.g. to maintain my mouth hygiene], social [e.g. the quality of treatment] and financial clusters [e.g. the reasonable cost]. Concerning barriers, financial factors [e.g. high cost] acted as the highest-rated barrier, followed by personal [e.g. lack of dental appointments] and health-related [e.g. worry that dental problems will worsen]. The social factors were the least considerable barrier [e.g. lack of time]. Clustering these facilitators/barriers on the concept map indicated their conceptual similarity by an average stress value of 0.23. CONCLUSION: Pain was the most important facilitator to attending oral health screening by young adults seeking tobacco cessation advice. Notable barriers included the high cost of dental treatment and the lack of scheduled appointments. Thus, oral health care providers need to consider scheduling periodic and timely dental check-ups to prevent and reduce the burden of tobacco-associated and pain-causing oral diseases.
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Emoções , Saúde Bucal , Adulto Jovem , Humanos , Movimento Celular , Análise por Conglomerados , DorRESUMO
INTRODUCTION: Smoking cessation is an important aspect of diabetes management. Despite the increased risk for diabetes complications when smoking, evidence suggests that people living with type 1 and type 2 diabetes are less likely to quit smoking when compared to those without diabetes. Guided by the Information-Motivation-Behavioral Skills model, this study aimed to identify the needs of individuals living with type 1 and type 2 diabetes to quit smoking. METHODS: A qualitative descriptive design was adopted. Semi-structured telephone interviews were held between April and June 2021, with 20 former and current Maltese smokers living with type 1 or type 2 diabetes, recruited from the diabetic clinics within the two main acute public hospitals. The interview transcriptions were analyzed using applied thematic analysis. RESULTS: Individuals with diabetes need more information on the effects of smoking on diabetes to encourage cessation. Preventing diabetic complications was reported as a motivator to quit smoking. However, having diabetes was identified as a challenge to quitting. Participants welcomed the provision of health professional support for quitting smoking, identifying the need to provide smoking cessation support within diabetic clinics. The provision of information on tobacco-associated diabetic complications, by using video messages featuring former smokers' stories was also suggested. CONCLUSIONS: To promote smoking cessation among individuals with diabetes, they need to be informed about how smoking affects their condition. Utilizing video messages featuring real-life stories of former smokers with diabetes who experienced tobacco-associated diabetic complications may be influential. Additionally, providing diabetes-specific intensive smoking cessation support is crucial to help them quit.
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Lifestyle medicine is a cornerstone of cardiovascular disease prevention and early disease intervention. A leading cause of death in developed countries, modifiable risk factors of cardiovascular disease like diet, exercise, substance use, and sleep hygiene have significant impacts on population morbidity and mortality. One should address these amendable risks in all patients, independently, and stress the importance of intervention adherence while avoiding the sacrifice of patient trust. One must also understand a patient's psychological well-being can be compromised by organic chronic disease states, and poor psychological well-being can have a negative impact on patient compliance and overall health.
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Doenças Cardiovasculares , Humanos , Doenças Cardiovasculares/epidemiologia , Fatores de Risco , Dieta , Estilo de Vida , Cooperação do PacienteRESUMO
Background: Tobacco use is undertreated in the medical setting. One driver may be inadequate tobacco use disorder treatment (TUDT) training for clinicians in specialties treating tobacco-dependent patients. Objective: We sought to evaluate the current state of TUDT training for diverse professionals and how these skills are assessed in credentialing exams. Methods: We performed a focused review of current educational practices, evidence-based strategies, and accreditation exam contents focused on TUDT. Results: Among medical students, participants in reviewed studies reported anywhere from 45 minutes to 3 hours of TUDT training throughout their 4-year programs, most often in the form of didactic sessions. Similarly, little TUDT training was reported at the post-graduate (residency, fellowship, continuing medical education) levels, and reported training was typically delivered as time-based (expected hours of instruction) rather than competency-based (demonstration of mastery) learning. Multiple studies evaluated effective TUDT curricula at varied stages of training. More effective curricula incorporated longitudinal sessions and active learning, such as standardized patient encounters or proctored patient visits. Knowledge of TUDT is minimally evaluated on certification exams. For example, the American Board of Internal Medicine blueprint lists TUDT as <2% of one subtopic on both the internal medicine and pulmonary exams. Conclusion: TUDT training for most clinicians is minimal, does not assess competency, and is minimally evaluated on certification exams. Effective, evidence-based TUDT training incorporating active learning should be integrated into medical education at all levels, with attention paid to inclusion on subsequent certifying exams.
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Abstract Introduction Despite the results of epidemiological and psychometric studies reporting comparable levels of tobacco dependence among males and females, some clinical studies have detected disparities. Some smoking cessation studies based on clinical setting programs reported poorer outcomes among women than men. Methods This retrospective cohort study aimed to compare treatment success and retention between men and women on a smoking cessation program (n = 1,014) delivered at a CAPS-AD unit in Brazil. The psychological intervention lasted 6 weeks for each group of 15 patients. Each patient had to participate in weekly group cognitive-behavioral therapy (CBT) sessions and individual medical appointments during this period. These appointments were focused on the possibility of prescribing pharmacological treatment (i.e., nicotine replacement therapy, bupropion, or nortriptyline) as adjuvants to group therapy. Results The women had lower smoking severity at baseline, more clinical symptoms, and lower prevalence of alcohol and drug use disorders and were older than the men. Females had significantly higher levels of success (36.6% vs. 29.7%) and retention (51.6% vs. 41.4%) than males. Sensitivity analysis showed that female gender was significantly associated with both retention and success, among those without drug use disorders only. Conclusion Depending on the smoking cessation setting (i.e., low and middle-income countries and mental health and addiction care units), females can achieve similar and even higher quit rates than males. Previous drug use disorder was an important confounding variable in the gender outcomes analyses. Future studies should try to replicate these positive smoking cessation effects of CBT-based group therapy plus pharmacotherapy in women.
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Objetivo Entre as diretrizes do Ministério da Saúde para controle do tabagismo está o Programa de Cessação do Tabagismo, desenvolvido pelo Instituto Nacional do Câncer. Esta revisão objetiva descrever as pesquisas que aplicaram o Programa de Cessação do Tabagismo, analisando seus procedimentos, efeitos, potencialidades e limitadores. Método Foram avaliados artigos das bases PubMed, PsycINFO, Biblioteca Virtual da Saúde e Biblioteca Eletrônica Científica Online publicados entre 2002 e 2019 e encontrados através de busca que usou os descritores: "Programa Nacional de Controle do Tabagismo" e "cessação do tabagismo" em português, espanhol e inglês. Foram pré-selecionados 1670 artigos, dos quais 15 foram elegíveis para análise final. Resultados Os resultados mostraram taxas de adesão ao tratamento de 33% a 100%, taxas de sucesso de 15% a 85% após a intervenção e de 21% a 51% seis meses após o final do tratamento. Essa variabilidade pode estar relacionada à falta de padronização e baixa fidelidade na aplicação do Programa, que propõe tratar as dependências física, psicológica e comportamental. Conclusão Recomenda-se investimento em capacitação técnica e monitoramento dos registros.
Objective Brazil Health Ministry's guidelines for tobacco control include the Smoking Cessation Program, developed by the Instituto Nacional de Câncer of Brazil. This review aims to describe the studies in which this Program has been applied, reviewing its procedures, effects, potential and limitations. Method Articles from PubMed, PsycINFO, Virtual Health Library and Scientific Electronic Library Online, published between 2002 and 2019, were evaluated, using the descriptors "Smoking Cessation Program" and "smoking cessation" in Portuguese, Spanish and English. A total of 1670 articles were pre-selected, of which 15 resulted eligible for final assessment. Results The results showed adherence rates from 33% to 100%, success rates from 15% to 85% after the intervention and 21% to 51% six months after treatment completion. This variability may be related to the lack of standardization and poor fidelity in the application of the Program, which intends to treat physical, psychological and behavioral dependence. Conclusion Investment in technical training and record monitoring is suggested.
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Tabagismo , Resultado do Tratamento , Abandono do Uso de Tabaco , Avaliação de Eficácia-Efetividade de IntervençõesRESUMO
ABSTRACT Background: peripheral arterial disease has smoking as its main avoidable vascular risk factor. However, most studies do not focus on smoking as the main exposure variable. Objectives: to assess the impact of smoking cessation interventions versus active comparator, placebo or no intervention, on peripheral arterial disease outcomes. Methods: we will use the Cochrane Handbook for Systematic Reviews of Interventions to guide whole this review process. We will consider parallel or cluster-randomised controlled trials (RCTs), quasi-RCTs, and cohort studies. We will search CENTRAL, MEDLINE, Embase, PsycINFO, LILACS and IBECS. We will also conduct a search of ClinicalTrials.gov and the ICTRP for ongoing or unpublished trials. Each research step will involve at least two independent reviewers. We will create a table, using GRADE pro GDT software, reporting the pooled effect estimates for the following outcomes: all-cause mortality, lower limb amputation, adverse events, walking distance, clinical severity, vessel or graft secondary patency, and QoL. Conclusions: we will assess these outcomes according to the five GRADE considerations to assess the certainty of the body of evidence for these outcomes, and to draw conclusions about the certainty of the evidence within the review.
RESUMO Introdução: a doença arterial periférica tem o tabagismo como principal fator de risco vascular evitável. Entretanto, a maioria dos estudos não destaca o tabagismo como principal variável de exposição. Objetivos: avaliar o impacto das intervenções de cessação do tabagismo versus comparador ativo, placebo ou nenhuma intervenção, nos desfechos da doença arterial periférica. Métodos: usaremos o Cochrane Handbook for Systematic Review of Interventions para orientar todo este processo de revisão. Consideraremos ensaios controlados paralelos ou randomizados por cluster (ECRs), quase-ECRs e estudos de coorte. Buscaremos no CENTRAL, MEDLINE, Embase, PsycINFO, LILACS e IBECS. ClinicalTrials.gov e ICTRP serão consultados para ensaios em andamento ou não publicados. Criaremos uma tabela, usando o software GRADE pro GDT, relatando as estimativas de efeito agrupado para os seguintes desfechos: mortalidade por todas as causas, amputação de membro inferior, eventos adversos, distância percorrida, gravidade clínica, permeabilidade secundária do vaso ou enxerto e qualidade de vida. Avaliaremos esses resultados de acordo com as cinco considerações GRADE para avaliar a certeza do corpo de evidências para esses resultados e tirar conclusões sobre a certeza das evidências na revisão.
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Introdução: o uso de produtos fumígenos derivados do tabaco é uma doença crônica não transmissível e uma das maiores mazelas mundiais em saúde pública. A atuação da Atenção Primária à Saúde na longitudinalidade do cuidado favorece o acolhimento dos tabagistas, sensibilização e aconselhamento para abandono deste hábito. Objetivos: analisar as taxas de abandono do hábito de fumar dentre os participantes do programa de combate ao tabagismo em um município da região metropolitana do Rio Grande do Sul. Métodos: trata-se de um corte transversal, retrospectivo, com análise dos registros de prontuários dos grupos no período de janeiro de 2018 a dezembro de 2021. Resultados: no total foram realizados 17 grupos de tratamento ao tabagismo no período, atendendo a 119 fumantes, em sua maioria mulheres e com média de 52,5±9,8 anos. Encontrou-se que 66,9% dos participantes deixaram de fumar até o quarto encontro. O uso de farmacoterapia (RC = 15,81; IC95%: 4,73 - 52,89), homens (RC = 1,62; IC95%: 0,68 - 3,90), estar presente em mais de quatro sessões (RC = 44,50; IC95%: 13,35 - 148,27) indivíduos com comorbidades do grupo cardiopatias (RC = 1,54; IC95%: 0,67 - 3,75) apresentaram maiores chances de abandono do tabagismo. Conclusões: A taxa de abandono do hábito de fumar foi superior nos participantes que comparecem a mais de quatro encontros, aqueles que tiveram moderado grau de dependência à nicotina, fumavam menos de um maço por dia, iniciaram a fumar jovens e apresentavam mais de 60 anos
Introduction: tobacco use is a major risk for noncommunicable diseases and one of the biggest illnesses in public health worldwide. The performance of Primary Health Care in the longitudinality of care favors the reception of smokers, awareness, and counseling for quitting this habit. Objectives: to analyze data about smoking cessation among integrants of the tobacco use cessation groups in Campo Bom/Rio Grande do Sul, Brazil. Methods: it's a crossectional observational study with a quantitative approach where we analyze secondary data from medical records of the group's cessation in the period from, January 2018 to December 2021. The present project was approved by the ethics research committee under the number: 5.583.858. Results: in total, 17 groups for tobacco use cessation were included during the period, serving 119 smokers, mostly women, and an average age of 52.5±9.8 years. It was found that 66.9% of the participants quit smoking until the fourth meeting. The pharmacotherapy use (OR = 15.81; IC95%: 4.73 52.89), male sex (OR = 1.62; IC95%: 0.68 3.90), being present on more than four sessions (OR = 44.50; IC95%: 13,35 - 148,27) and individuals of the cardiopathy group comorbidity (OR = 1.54; IC95%: 0.67 3.75) had higher chances on tobacco use cessation. Conclusions: The rate of tobacco use cessation was higher in those persons who participated in more than four meetings, had a moderate degree of nicotine dependence, smoked less than a pack by day, started smoking at a younger age, and were over 60 years old
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Tabagismo , Estudos TransversaisRESUMO
ABSTRACT Objective: To identify the potential determinants of tobacco counseling implementation among oral health professionals in India. Material and Methods: A cross-sectional survey was carried out among the 298 dentists of Aligarh and Gwalior. The questionnaire used in the study had sections on dentists' sociodemographic data and a 35-item questionnaire to assess the potential determinants of tobacco cessation counseling. Descriptive statistics were carried out, and a Chi-square test was utilized to determine the association. P-value <0.05 was considered statistically significant. Results: Domains "knowledge", "Professional Responsibility and Identity", and "Remembrance, awareness, and judgment" showed a statistically significant correlation with most tobacco cessation counseling behaviors. In addition, undergraduate education received in Tobacco Cessation counseling, and Continuing education received in Tobacco Cessation counseling had significantly impacted the practice of tobacco cessation counseling (p=0.02 and 0.04, respectively). Conclusion: This study suggests that "Knowledge", "Professional Responsibility and Identity" and "Remembrance, awareness, and judgment" are the potential determinants that could be used to design effective strategies to enhance tobacco counseling among dentists in India.
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Humanos , Masculino , Feminino , Nicotiana/efeitos adversos , Saúde Bucal/educação , Abandono do Uso de Tabaco , Tabagismo/epidemiologia , Estudos Transversais/métodos , Inquéritos e Questionários , Política de Saúde , Índia/epidemiologiaRESUMO
Resumo O tabagismo é um problema de saúde pública, está associado a uma elevada morbimortalidade. Os serviços de saúde vigentes para a cessação tabágica, apesar de efetivos, apresentam alcance limitado e foram comprometidos pela pandemia. O estudo teve como objetivo analisar o cuidado com a pessoa tabagista em João Pessoa (PB), na pandemia de COVID-19. Foi realizado um estudo descritivo, exploratório e quantitativo com duas fases: levantamento dos indicadores de saúde e avaliação dos perfis sociodemográficos dos profissionais e usuários dos serviços nos anos do estudo. Participaram da pesquisa sete profissionais, coordenadores de grupo de tabagismo e 20 usuários. Os resultados apontaram para uma baixa cobertura do programa, além de revelar queda no número de fumantes atendidos na pandemia, de 419 em 2019 para 129 em 2020. As entrevistas identificaram pontos positivos e limitações do programa, boa efetividade e baixo acesso, especialmente na APS, e que as estratégias utilizadas para conter o consumo do tabaco e seus riscos durante a pandemia partiram dos serviços e dos profissionais envolvidos. É possível concluir que, nessa região, o Programa Nacional de Controle do Tabagismo (PNCT) apresenta implantação incipiente na APS e que, durante a pandemia, o número de serviços ofertados foi reduzido, diminuindo a procura e as ações realizadas.
Abstract Smoking is a public health problem associated with high morbimortality. Smoking cessation services, although effective, have limited reach and have been compromised by the pandemic. This study aimed to analyze the care for smokers in João Pessoa (PB), Brazil, during the COVID-19 pandemic. A descriptive, exploratory, and quantitative study was conducted in two phases: a survey of health indicators and an evaluation of sociodemographic profiles of professionals and service clients during the study years. Seven professionals, smoking group coordinators, and 20 clients participated in the research. The results showed low program coverage, with a declining number of smokers treated during the pandemic, down from 419 in 2019 to 129 in 2020. Interviews identified the program's positive aspects and limitations, good effectiveness, and low access, especially in primary health care. Tobacco consumption and risk reduction strategies during the COVID-19 pandemic originated from services and professionals involved. We can conclude that the National Tobacco Control Program has an incipient implementation in primary health care in this region and that the number of services offered was reduced during the pandemic, decreasing demand and actions.
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Introducción. El consumo de tabaco representa un importante desafío para la salud pública debido a su alta incidencia y mortalidad, y es el principal factor de riesgo modificable para desarrollar enfermedades crónicas no transmisibles. La Residencia de Medicina General y Familiar del Hospital General de Agudos Dr. Teodoro Álvarez desarrolló un programa de cesación tabáquica en el Centro de Salud y Acción Comunitaria Nâ¦34, que forma parte desde 2012 del Programa de Prevención y Control del Tabaquismo del Ministerio de Salud del Gobierno de la Ciudad de Buenos Aires, Argentina. Objetivo. Documentar los resultados de la eficacia de este programa y explorar las variables relacionadas con la probabilidad de éxito y recaída. Materiales y métodos. Estudio cuantitativo, de corte transversal analítico, con datos obtenidos de historias clínicas electrónicas entre 2017 y 2020. Fueron incluidos los pacientes que consultaron al menos en dos ocasiones al programa de cesación tabáquica y establecieron un día D al menos 30 días antes del abandono del consumo de tabaco. La eficacia terapéutica fue definida como haber permanecido al menos seis meses sin fumar, y la recaída, como el reinicio de consumo del tabaco luego de haber logrado 24 horas de abstinencia con fecha posterior al día D.Resultados.De 59 pacientes, 24 (40,7 %) lograron la eficacia terapéutica, de los cuales 5 (20,8 %) presentaron recaídas.De los 35 pacientes que no lograron alcanzar la etapa de mantenimiento, 30 (85,7 %) recayeron durante las primeras ocho semanas. El sexo masculino y el consumo de tabaco superior a 20 paquetes-año mostraron una mayor correlación con las recaídas. Conclusiones. El programa presentó una eficacia terapéutica del 40,7 % en el periodo evaluado. Se encontraron asociaciones entre una mayor eficacia terapéutica y ciertas características de los pacientes, pero se requieren más estudios para confirmar esta hipótesis. (AU)
Background. Tobacco consumption represents an important challenge for public health due to its high incidence and mortality and is the main modifiable risk factor for developing chronic non-communicable diseases. The General and Family Medicine Residence of the Hospital General de Agudos Dr. Teodoro Álvarez developed a smoking cessation program in Health and Community Action Centre Nâ¦34. Since 2012 it has been part of the Program for the Prevention and Control of Smoking of the Ministry of Health of the Government of Buenos Aires, Argentina. Objective. To document the results of the effectiveness of the program and explore the variables related to the probability of success and relapse. Materials and methods. Quantitative, analytical cross-sectional study, with data obtained from electronic medical records between 2017 and 2020. Patients who consulted the smoking cessation program at least twice and established a D-day 30 days before quitting tobacco consumption were included. Therapeutic efficacy was defined as having remained at least six months without smoking, and relapse, as the resumption of tobacco consumption after having achieved 24 hours of abstinence with a date after day D. Results. Of 59 patients, 24 (40.7 %) achieved therapeutic efficacy, of which 5 (20.8 %) presented relapses. Among the35 patients who failed to reach the maintenance stage, 30 (85.7 %) relapsed during the first eight weeks. Male sex and tobacco consumption of more than 20 pack per year showed a greater correlation with relapses. Conclusions.The program presented a therapeutic efficacy of 40.7 % in the evaluated period. Associations were found between greater therapeutic efficacy and certain patient characteristics but more studies are required to confirm this hypothesis. (AU)
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Tabagismo/terapia , Resultado do Tratamento , Abandono do Hábito de Fumar/métodos , Abandono do Uso de Tabaco/métodos , Recidiva , Tabagismo/prevenção & controle , Avaliação de Resultado de Intervenções Terapêuticas , Estudos Transversais , Interpretação Estatística de Dados , Abandono do Hábito de Fumar/estatística & dados numéricos , Abandono do Uso de Tabaco/estatística & dados numéricos , Controle do TabagismoRESUMO
Objective.To assess the effectiveness of a brief intervention and motivational interviewing in reducing the use of different tobacco-related products in adults Methods. Forthis systematic review, PubMed, Web of Science, and PsychINFO databases were electronically searched for randomized controlled trials on the effect of a brief intervention and / or motivational interview on tobacco reduction among healthy adults published between January 1, 2011 to January 1, 2021. Data from eligible studies were extracted and analyzed. CONSORT guidelines were used to assess the quality of the studies by two reviewers for the included studies. The titles and abstracts of the search results were screened and reviewed by two independent reviewers for eligibility criteria per the inclusion and exclusion criteria. Cochrane review criteria were used to assess the risk of bias in included studies. Results. A total of 12 studies were included in the final data extraction of 1406 studies. The brief intervention and motivational interviewing showed varied effects on tobacco use reduction among adults at different follow-ups. Seven of the 12 studies (58.3%) reported a beneficial impact on reducing tobacco use. Pieces of evidence on biochemical estimation on tobacco reduction are limited compared to self-reports, and varied results on quitting and tobacco cessation with different follow-ups. Conclusion. The current evidence supports the effectiveness of a brief intervention and motivational interviewing to quit tobacco use. Still, it suggests using more biochemical markers as outcome measures to reach an intervention-specific decision. While more initiatives to train nurses in providing non-pharmacological nursing interventions, including brief interventions, are recommended to help people quit smoking.
Objetivo. Evaluar la eficacia de una intervención breve y de la entrevista motivacional para reducir el consumo de diferentes productos relacionados con el tabaco en adultos. Métodos. Para esta revisión sistemática, se buscaron en las bases de datos PubMed, Web of Science y PsychINFO ensayos controlados aleatorizados sobre el efecto de una intervención breve y/o una entrevista motivacional en la reducción del consumo de tabaco entre adultos sanos, que hubieran sido publicados entre el 1 de enero de 2011 y el 1 de enero de 2021. Los títulos y los resúmenes de los artículos incluidos fueron evaluados por dos revisores independientes para determinar los criterios de elegibilidad, se analizó la calidad de los estudios con la guía CONSORT y se utilizaron los criterios de Cochrane para evaluar el riesgo de sesgo.Resultados.Se incluyeron un total de 12 de los 1406 estudios que arrojó la búsqueda. La intervención breve y la entrevista motivacional mostraron efectos variados en la reducción del consumo de tabaco entre los adultos en diferentes seguimientos. Siete de los 12 estudios (58.3%) informaron de un impacto beneficioso en la reducción del consumo de tabaco. La utilización de indicadores bioquímicos de la reducción del consumo de tabaco fueron limitados en comparación con los autoinformes. Los resultados sobre el abandono y la cesación del tabaco fueron variados con diferentes seguimientos. Conclusión.La evidencia apoyó la efectividad de una intervención breve y de la entrevista motivacional para la cesación del consumo de tabaco. Sin embargo, se sugiere realizar más estudios con marcadores bioquímicos como medidas de resultado para llegar a una decisión específica de la intervención. Se recomienda formar a los enfermeros en la realización de intervenciones de enfermería no farmacológicas, incluidas las intervenciones breves, para ayudar a las personas a dejar de fumar.
Objetivo. Avaliar a eficácia de uma intervenção breve e entrevista motivacional na redução do uso de diferentes produtos relacionados ao tabaco em adultos. Métodos.Para esta revisão sistemática, se buscou nas bases de PubMed, Web of Science e PsychINFO ensaios controlados aleatórios sobre o efeito de uma breve intervenção e/ou entrevista motivacional na redução do uso de tabaco entre adultos saudáveis, publicados entre 1º de janeiro de 2011 e 1º de janeiro de 2021. Os títulos e resumos dos artigos incluídos foram avaliados por dois revisores independentes para critérios de elegibilidade, a qualidade do estudo foi avaliada usando a diretriz CONSORT e os critérios Cochrane foram usados para avaliar o risco de viés. Resultados. Um total de 12 dos 1.406 estudos retornados pela busca foram incluídos. Intervenção breve e entrevista motivacional mostraram efeitos mistos na redução do uso de tabaco entre adultos em diferentes acompanhamentos. Sete dos 12 estudos (58.3%) relataram um impacto benéfico na redução do uso de tabaco. O uso de indicadores bioquímicos de redução do uso de tabaco foi limitado em relação ao autorrelato. Os resultados sobre parar de fumar e parar de fumar foram variados com diferentes seguimentos. Conclusão. As evidências apoiaram a eficácia de uma intervenção breve e entrevista motivacional para a cessação do uso do tabaco. No entanto, mais estudos com marcadores bioquímicos como medidas de resultados são sugeridos para chegar a uma decisão de intervenção específica. Recomenda-se que os enfermeiros sejam treinados na execução de intervenções de enfermagem não farmacológicas, incluindo intervenções breves, para ajudar as pessoas a parar de fumar.
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Adulto , Abandono do Uso de Tabaco , Entrevista Motivacional , Uso de TabacoRESUMO
Resumo Introdução O tabagismo é uma das principais causas evitáveis de doenças e um grande desafio para a saúde pública, sendo a Atenção Primária à Saúde (APS) o nível de atenção à saúde com maior potencial de manejo da cessação de uso de tabaco. Objetivo O objetivo foi descrever os resultados de cessação de tabaco em grupos inseridos em um programa público de tratamento do tabagismo ao longo de 11 anos. Método Estudo retrospectivo do tipo série histórica dos grupos de tabagismo desenvolvido no período de 2006 a 2016 nas 12 unidades de saúde do Serviço de Saúde Comunitária do Grupo Hospitalar Conceição (GHC), Porto Alegre-RS. Os dados foram coletados nos Relatórios Anuais de Indicadores de Saúde e no Sistema de Informações do GHC. Análises descritivas foram realizadas por meio de frequências absolutas e relativas. Resultados Dos 2.691 tabagistas acompanhados, 1.273 (47%) deixaram de fumar até a quarta sessão do grupo. Discussão A cessação de tabaco em grupos contribuiu para que mais da metade dos participantes conseguisse parar de fumar ao longo do período de 4 semanas de tratamento em grupo. Esta é uma importante estratégia terapêutica acessível e eficiente para auxiliar e oportunizar um atendimento integral aos usuários tabagistas no contexto da APS.
Abstract Background Smoking is one of the main preventable causes of diseases and a major challenge for public health. Primary Health Care (PHC) is the level of health care with the greatest potential for managing tobacco cessation. Objective The objective was to describe the results of smoking cessation in groups included in a public smoking treatment program over 11 years. Methods Retrospective study of the historical series type of smoking groups developed between 2006 and 2016 in the 12 health units of the Community Health Service of Grupo Hospitalar Conceição (GHC), Porto Alegre-RS. Data were collected in the Annual Health Indicator Reports and the GHC Information System. Descriptive analyzes were performed using absolute and relative frequencies. Results Of the 2,691 smokers monitored, 1,273 (47%) quit smoking until the fourth session of the group. Discussion Smoking cessation in groups contributed to more than half of the participants being able to quit smoking over 4 weeks of treatment groups. This is an important accessible and efficient therapeutic strategy to assist and provide comprehensive care to smokers in the context of PHC.
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Introdução: A pandemia do novo coronavírus teve repercussões no funcionamento dos sistemas de saúde do mundo inteiro. O tabagista foi um grupo diretamente afetado por essas mudanças. Objetivo: Mensurar esse impacto a partir da análise dos dados do Programa Estadual de Controle ao Tabagismo de Pernambuco. Método: Estudo descritivo transversal, utilizando como unidades de análise dados da estratégia de monitoramento do Programa Estadual de Controle ao Tabagismo da Secretaria Estadual de Saúde de Pernambuco (SES-PE), comparando os atendimentos no segundo quadrimestre dos anos de 2019 e 2020. Resultados: Entre maio e agosto de 2019, 3.282 pacientes tabagistas buscaram tratamento para cessação do tabagismo no SUS, em Pernambuco. Em período similar, entre os meses de maio e agosto do ano de 2020, o tratamento para cessação do tabagismo foi procurado por 680 usuários tabagistas, representando uma queda de 79,28%. Além disso, o número de municípios oferecendo tratamento para cessação do tabagismo no SUS caiu de 97 para 36 (62,89%) e o número de unidades de saúde da atenção básica realizando tratamento para cessação do tabagismo no SUS de 277 para 80 (71,11%). Conclusões: A diminuição da oferta do tratamento pelo Programa Estadual de Combate ao Tabagismo é preocupante. Ainda que a sua relação com a COVID-19 não esteja completamente elucidada, a cessação do uso do tabaco traz benefícios já bem estabelecidos. Dessa forma, é necessário incentivar a adoção de novas estratégias e tecnologias, aproveitando a janela de oportunidade que o temor da associação COVID-19/tabagismo criou.
Introduction: The new Coronavirus pandemic has had an impact on health systems worldwide. Smokers were directly aï¬ected by these changes. Objective: To measure the new Coronavirus pandemic impact on smoking cessation from the analysis of data from the Pernambuco State Tobacco Control Program. Method: Descriptive cross-sectional study, using data from the monitoring strategy of the State Tobacco Control Program of the State Health Secretariat of Pernambuco (SES-PE) as the unit of analysis, comparing services in the second quarter of 2019 and 2020. Results: Between May and August 2019, 3.282 smoking patients sought treatment for smoking cessation in SUS, in Pernambuco. In a similar period, between the months of May and August of the year 2020, treatment for smoking cessation was sought by 680 smoking users, representing a drop of 79,28%. In addition, the number of municipalities oï¬ering treatment for smoking cessation in SUS dropped from 97 to 36 (62,89%) and the number of primary health care units providing treatment for smoking cessation in SUS went from 277 to 80 (71,11%). Conclusions: The decrease in the oï¬er of treatment by the State Program to Combat Smoking is worrying. Although its relation with COVID-19 has not been fully elucidated, the cessation of tobacco use has already established benefts. Thus, it is necessary to encourage the adoption of new strategies and technologies, using the window of opportunity that the fear of COVID-19/smoking association created.
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Abstract Objective: to assess the effects of an educational intervention on smoking cessation aimed at the nursing team. Method: this is a quasi-experimental study with 37 nursing professionals from a Brazilian hospital from May/2019 to December/2020. The intervention consisted of training nursing professionals on approaches to hospitalized smokers divided into two steps, the first, online, a prerequisite for the face-to-face/videoconference. The effect of the intervention was assessed through pre- and post-tests completed by participants. Smokers' medical records were also analyzed. For analysis, McNemar's chi-square test was used. Results: there was an increase in the frequency of actions aimed at smoking cessation after the intervention. Significant differences were found in guidelines related to disclosure to family members of their decision to quit smoking and the need for support, encouragement of abstinence after hospital discharge, and information on tobacco cessation and relapse strategies. Conclusion: the educational intervention proved to be innovative and with a great capacity for disseminating knowledge. The post-test showed a positive effect on the frequency of actions aimed at smoking cessation implemented by the nursing team.
RESUMEN Objetivo: evaluar los efectos de una intervención educativa para dejar de fumar dirigida al equipo de enfermería. Método: estudio cuasi-experimental con 37 profesionales de enfermería de un hospital brasileño de mayo/2019 a diciembre/2020. La intervención consistió en capacitar a los profesionales de enfermería en el abordaje del paciente fumador, dividida en dos etapas, la primera, en línea, requisito previo para la presencial/videoconferencia. El efecto de la intervención se evaluó a través del pre y post test realizado por los participantes. También se analizaron los registros en las historias clínicas de los fumadores. Para el análisis se utilizó la prueba Chi-Square de McNemar. Resultados: hubo un aumento en la frecuencia de acciones dirigidas a dejar de fumar después de la intervención. Se encontraron diferencias significativas en las guías relacionadas con la divulgación a los familiares de la decisión de dejar de fumar y la necesidad de apoyo, el estímulo de la abstinencia después del alta hospitalaria y la información sobre estrategias para dejar de fumar y recaer. Conclusión: la intervención educativa demostró ser innovadora y con gran capacidad de diseminación del conocimiento. El post-test mostró un efecto positivo en la frecuencia de las acciones dirigidas a la deshabituación tabáquica implementadas por el equipo de enfermería.
RESUMO Objetivo: avaliar os efeitos de uma intervenção educativa sobre cessação do tabagismo direcionada à equipe de enfermagem. Método: estudo quase-experimental com 37 profissionais de enfermagem de um hospital brasileiro de maio/2019 a dezembro/2020. A intervenção consistiu em capacitar profissionais de enfermagem sobre abordagens aos pacientes tabagistas, dividida em duas etapas, a primeira, online, pré-requisito para a presencial/videoconferência. O efeito da intervenção foi avaliado por meio do pré- e pós-teste preenchido pelos participantes. Também foram analisados registros em prontuários de pacientes fumantes. Para análise, utilizou-se o Teste do Qui-Quadrado de McNemar. Resultados: houve aumento da frequência das ações visando à cessação tabágica após a intervenção. Diferenças significativas foram encontradas em orientações relacionadas à divulgação aos familiares da decisão de parar de fumar e necessidade de apoio, incentivo à abstinência após alta hospitalar e informações sobre estratégias para cessação do tabaco e recaídas. Conclusão: a intervenção educativa se mostrou inovadora e com grande capacidade de difusão do conhecimento. O pós-teste evidenciou efeito positivo na frequência das ações visando à cessação tabágica implementadas pela equipe de enfermagem.
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Abandono do Uso de Tabaco , Educação Continuada em Enfermagem , Ensino , Educação em Saúde , Equipe de EnfermagemRESUMO
Objetivo: Descrever os indicadores de abandono do uso de tabaco, em 2013 e 2019, para o Brasil e as Unidades da Federação, segundo variáveis sociodemográficas, coletadas na Pesquisa Nacional de Saúde (PNS). Métodos: Estudo transversal, populacional e descritivo realizado com dados da PNS 2013 e 2019, uma pesquisa domiciliar coletada por entrevistadores treinados. Foram calculadas a prevalência de ex-fumantes e a proporção de fumantes que tentaram parar de fumar nos últimos 12 meses imediatamente anteriores à data da entrevista, e os respectivos intervalos de confiança (IC95%), segundo as variáveis sociodemográficas. Ademais, calculou-se a variação percentual entre os anos estudados. Resultados: Em 2013, a prevalência de ex-fumantes foi 17,5% (IC95% 16,9;18,0) e, em 2019, 26,6% (IC95% 26,1;27,2). Tentaram parar de fumar 51,1% (IC95% 49,3;52,9), em 2013, e 46,6% (IC95% 45,0;48,3) em 2019. Conclusão: É importante o fortalecimento e manutenção de estratégias para enfrentamento do uso de tabaco no país, de forma a aumentar a disposição e a capacidade do fumante atual de parar de fumar.
Objetivo: Describir los indicadores de abandono del hábito tabáquico en 2013 y 2019 para Brasil y Unidades Federadas, según variables sociodemográficas, recogidas en la Encuesta Nacional de Salud (PNS). Métodos: Estudio transversal, poblacional y descriptivo con datos de las PNS, 2013 y 2019, una encuesta de hogares recolectada por entrevistadores capacitados. Se calculó la prevalencia de exfumadores y proporción de fumadores que intentaron dejar de fumar en los últimos 12 meses y respectivos intervalos de confianza (IC95%), según variables sociodemográficas. Además, se calculó la variación porcentual entre los años. Resultados: En 2013, la prevalencia de exfumadores fue de 17,5% (IC95% 16,9;18,0), en 2019, 26,6% (IC95% 26,1;27,2). En 2013, el 51,1% intentó dejar de fumar (IC95% 49,3;52,9), y, en 2019, el 46,6% (IC95% 45,0;48,3). Conclusión: Es importante fortalecer y mantener las estrategias de afrontamiento del tabaquismo, para incrementar la disposición y capacidad del fumador actual para dejar de fumar.
Objective: To describe the indicators of smoking cessation in 2013 and 2019 for Brazil and federative units, according to sociodemographic variables, collected in the National Health Survey (PNS). Methods: Cross-sectional, population-based and descriptive study with data from the 2013 and 2019 PNS, a household survey collected by trained interviewers. The prevalence of ex-smokers and the proportion of smokers who tried to quit smoking in the 12 months prior to the interview, and respective confidence intervals (95%CI) were calculated, according to sociodemographic variables. Additionally, the percentage variation between the years was calculated. Results: In 2013, the prevalence of ex-smokers was 17.5% (95%CI 16.9;18.0) and, in 2019, 26.6% (95%CI 26.1;27.2). In 2013, 51.1% tried to quit smoking (95%CI 49.3;52.9) and, in 2019, 46.6% (95%CI 45.0;48.3). Conclusion: It is important to strengthen and maintain strategies for coping with tobacco use in Brazil, to increase the current smoker's willingness and ability to quit smoking.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Tabagismo/epidemiologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Ex-Fumantes/estatística & dados numéricos , Brasil/epidemiologia , Inquéritos EpidemiológicosRESUMO
We aimed to evaluate concurrent use of alcohol and tobacco among hospitalized patients as well as to compare the use of both substances among people living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome and those with other diagnoses. A cross-sectional study took place in a hospital in Minas Gerais (Brazil). Structured surveys were used to evaluate tobacco and alcohol use. Data analysis was conducted using descriptive statistics and chi-square test. We interviewed 972 patients, in which 20.3% were hazardous drinkers and 14.9% tobacco users. Almost half of the smokers (47.6%) were hazardous drinkers, while 15.5% of nonsmokers engaged in harmful consumption of alcohol (p < 0.001). Tobacco use was higher among people living with Human Immunodeficiency Virus when compared with patients that did not have an Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome diagnosis (32.1% vs 14.4%, p = 0.009). Our findings showed the association of tobacco use and hazardous drinking among hospitalized patients in Brazil and a higher prevalence of tobacco use among patients living with Human Immunodeficiency Virus. These findings can be used to develop smoking cessation interventions that address the comorbidities associated with substance use.
O presente estudo teve como objetivo avaliar a associação do uso de álcool e tabaco entre pacientes internados em um hospital geral e comparar o uso das duas substâncias entre pacientes que vivem com o Vírus da Imunodeficiência Humana/Síndrome de Imunodeficiência Adquirida e outros diagnósticos. Realizou-se um estudo observacional em um hospital público para avaliação do uso de tais substâncias. Entre 972 pacientes, 20,3% fizeram uso prejudicial de álcool e 14,9% de tabaco. Quase metade dos tabagistas (47,6%) fizeram uso prejudicial do álcool, enquanto 15,5% dos não tabagistas relataram uso excessivo da substância (p < 0,001). A porcentagem de fumantes foi significativamente mais alta no grupo de pacientes que vivem com o Virus da Imunodeficiência Humana do que nos demais diagnósticos (32,1% vs 14,4%, p = 0,009). Percebe-se a associação do uso de tabaco e uso prejudicial de álcool entre pacientes hospitalizados e alta prevalência do uso de tabaco entre pacientes que vivem com o Vírus da Imunodeficiência Humana/Síndrome de Imunodeficiência Adquirida. Esses dados podem direcionar o planejamento de intervenções para cessação do consumo de tabaco que consigam direcionar as comorbidades relacionadas ao uso da substância